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Revision as of 21:08, 18 September 2015
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*EMRs can greatly reduce or make more efficient use of time.
*EMRs can greatly reduce or make more efficient use of time.
A recent study (July-2015)EMR decision support systems where proven to have reduced and or made more efficient use of the time needed for “Colorectal cancer screening where the immediate harms are balanced with longer-term benefits.” By providing a “personalized benefit/harm assessment”. <ref name="Cost vs Time"> Cost vs Time http://www.ajmc.com/journals/issue/2015/2015-vol21-n7/Pilot-of-Decision-Support-to-Individualize-Colorectal-Cancer-Screening-Recommendations/</ref>
A recent study (July-2015)EMR decision support systems where proven to have reduced and or made more efficient use of the time needed for “Colorectal cancer screening where the immediate harms are balanced with longer-term benefits.” By providing a “personalized benefit/harm assessment”. <ref name="Cost vs Time"> Cost vs Time http://www.ajmc.com/journals/issue/2015/2015-vol21-n7/Pilot-of-Decision-Support-to-Individualize-Colorectal-Cancer-Screening-Recommendations/</ref>
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==Implementaion==
==Implementaion==
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*preparations for implementation and after.
*preparations for implementation and after.
The journal of Emergency medicine titled with "computers in Emergency medicine" talks about all aspects of EHR implementation. <ref name="implementation"> IMPLEMENTING ELECTRONIC HEALTH RECORDS IN THE
The journal of Emergency medicine titled with "computers in Emergency medicine" talks about all aspects of EHR implementation. <ref name="implementation"> IMPLEMENTING ELECTRONIC HEALTH RECORDS IN THE
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EMERGENCY DEPARTMENT. http://www.jem-journal.com/article/S0736-4679(08)00321-1.
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EMERGENCY DEPARTMENT. http://www.jem-journal.com/article/S0736-4679(08)00321-1.
</ref>
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</ref>
=== Neonatal Informatics and CPOE ===
=== Neonatal Informatics and CPOE ===
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While studies have shown these benefits to be consistent with CPOE and CDS equipped institutions, the effects of these systems on morbidity and mortality have been ambiguous. A 2005 article reported an increase in mortality rate with the implementation of an EMR system with CPOE in a pediatric intensive care unit (PICU).<ref>Han, Y.Y., Carcillo, J.A., Venkataraman, S.T., et al. Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system. Pediatrics. 2005;116:1506-1512. [PubMed: 16322178].</ref> The informaticists and hospital administration, determined that errors with the implementation process of the CPOE system resulted in these negative results. They stressed that a change in the workflow design was essential for a safer CPOE implementation. A more recent 2010 article reported a decrease in neonatal mortality rate using the exact same CPOE system.<ref>Longhurst, C.A., Parast, L., Sandborg, C.I. et al. Decrease in hospital-wide mortality rate after implementation of a commercially sold computerized physician order entry system. Pediatrics. 2010;126:14-21. [PubMed: 20439590].</ref>These findings indicate that the implementation of the CPOE system needs to include careful consideration of workflow analysis. However, even with the utmost attention being given to ensure the safety of a new CPOE system, inadvertent issues may still arise with human error. An example of such would be a physician order entry on the wrong patient.<ref name="Palma 2011">Palma, J.P., Sharek, P.J., Classen, D.C., & Longhurst, C.A. (2011). Neonatal Informatics: Computerized Physician Order Entry. Neoreviews. 12:393-396. http://www-ncbi-nlm-nih-gov.ezproxyhost.library.tmc.edu/pmc/articles/PMC3146345/</ref>
While studies have shown these benefits to be consistent with CPOE and CDS equipped institutions, the effects of these systems on morbidity and mortality have been ambiguous. A 2005 article reported an increase in mortality rate with the implementation of an EMR system with CPOE in a pediatric intensive care unit (PICU).<ref>Han, Y.Y., Carcillo, J.A., Venkataraman, S.T., et al. Unexpected increased mortality after implementation of a commercially sold computerized physician order entry system. Pediatrics. 2005;116:1506-1512. [PubMed: 16322178].</ref> The informaticists and hospital administration, determined that errors with the implementation process of the CPOE system resulted in these negative results. They stressed that a change in the workflow design was essential for a safer CPOE implementation. A more recent 2010 article reported a decrease in neonatal mortality rate using the exact same CPOE system.<ref>Longhurst, C.A., Parast, L., Sandborg, C.I. et al. Decrease in hospital-wide mortality rate after implementation of a commercially sold computerized physician order entry system. Pediatrics. 2010;126:14-21. [PubMed: 20439590].</ref>These findings indicate that the implementation of the CPOE system needs to include careful consideration of workflow analysis. However, even with the utmost attention being given to ensure the safety of a new CPOE system, inadvertent issues may still arise with human error. An example of such would be a physician order entry on the wrong patient.<ref name="Palma 2011">Palma, J.P., Sharek, P.J., Classen, D.C., & Longhurst, C.A. (2011). Neonatal Informatics: Computerized Physician Order Entry. Neoreviews. 12:393-396. http://www-ncbi-nlm-nih-gov.ezproxyhost.library.tmc.edu/pmc/articles/PMC3146345/</ref>
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== Specialty clinics ==
== Specialty clinics ==
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EHR’s can significantly improve the productivity for specialty physician clinics such as for ophthalmology. Incorporating an EHR, a clinic can reduce process and time spent on recording patient data, as most diagnostic equipment can communicate with EHR’s. With medical and diagnostic equipment communicating with EHR’s, staff and technicians can focus more on the patient. <Ref name==
”Misch
,
2012”
> Misch, D.M. Specialty-specific EHR system benefits both practice, patients: technologic innovation: how using EHR, practice management platform can improve standard of care and efficiency. http://go.galegroup.com.ezproxyhost.library.tmc.edu/ps/i.do?p=HRCA&u=txshracd2509&id=GALE|A312290264&v=2.1&it=r&sid=summon&userGroup=txshracd2509
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EHR’s can significantly improve the productivity for specialty physician clinics such as for ophthalmology. Incorporating an EHR, a clinic can reduce process and time spent on recording patient data, as most diagnostic equipment can communicate with EHR’s. With medical and diagnostic equipment communicating with EHR’s, staff and technicians can focus more on the patient. <Ref name==
"Misch
,
2012"
> Misch, D.M. Specialty-specific EHR system benefits both practice, patients: technologic innovation: how using EHR, practice management platform can improve standard of care and efficiency. http://go.galegroup.com.ezproxyhost.library.tmc.edu/ps/i.do?p=HRCA&u=txshracd2509&id=GALE|A312290264&v=2.1&it=r&sid=summon&userGroup=txshracd2509
</ref>
== Benefits Database ==
== Benefits Database ==
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==Compliance==
==Compliance==
[[EMR Benefits: Compliance]]
[[EMR Benefits: Compliance]]
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18. Hillestad, R., Bigelow, J., Bower, A., Girosi, F., Meili, R., Scoville, R., & Taylor, R. (2005). Can Electronic Medical Record Systems Transform Health Care? Potential Health Benefits, Savings, And Costs. Health Affairs, 1103-1117. doi:10.1377/hlthaff.24.5.1103 Health Aff September 2005 vol. 24 no. 5 1103-1117
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== References ==
== References ==
<references/>
<references/>
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[[Category: EHR]]
[[Category: EHR]]
[[Category: EMR]]
[[Category: EMR]]
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18. Hillestad, R., Bigelow, J., Bower, A., Girosi, F., Meili, R., Scoville, R., & Taylor, R. (2005). Can Electronic Medical Record Systems Transform Health Care? Potential Health Benefits, Savings, And Costs. Health Affairs, 1103-1117. doi:10.1377/hlthaff.24.5.1103 Health Aff September 2005 vol. 24 no. 5 1103-1117